When the COVID-19 virus erupted, programs to control the HIV virus came to a halt in nearly all countries. For Rwandan men though, they continued flocking to health centers for circumcision to protect themselves against the HIV/Aids virus.
Newly released data by the UN aids agency UNAIDS shows that while circumcision stopped elsewhere, it had increased by 15 percent in Rwanda by the end of 2020.
Government in Rwanda has committed to ensure 400,000 men are circumcised every year through the so called voluntary male medical circumcision (VMMC). This basically means men willingly walking into health facilities to be circumcised.
Studies have confirmed that circumcision offers protection from getting the HIV virus that causes Aids by more than 68%. The World Health Organization (WHO) and UNAIDS have fronted circumcision done safely by medical personnel as best shot at controlling HIV – as other control measures like condom use have various challenges.
However, at the end of 2019 and the whole of 2020, the entire world has been focused on the COVID-19 virus. Lockdowns have prevented circumcision programs, as with all other programs.
In Rwanda, for 2019, health ministry data shows that some 349,000 men were circumcised. Now, the new UNAIDS figures are indicating that by end of 2020, that figure had grown by 15% or 52,350 men.
It suggests that for the first time since government vowed to circumcise 400,000 men annually, Rwanda exceeded its target by 1,350 men.
Currently, 40% of the male population in Rwanda has been circumcised. The health ministry wants that to grow to at least 70%.
Rwandan health officials say circumcision generally protects men from the risk of contracting HIV by over 60 per cent. However, this percentage is very effective in a country where you have around 70 per cent of males circumcised.
Nyanza district is in Rwanda’s Southern Province, which has low uptake of male circumcision when compared to other provinces (17.3%). It has the second-highest HIV prevalence after Kigali (3.2%).
Nyanza particularly has high sexually transmitted infections (STI) prevalence on a national level, is eighth in HIV prevalence nationally, has a low male circumcision rate (15%). As for voluntary medical circumcisions, uptake in Nyanza is the lowest nationwide.
Globally, UNAIDS said in its latest report that many countries suspended their programmes when the pandemic took hold, including South Africa, where service coverage has been declining since 2018.
Despite the coronavirus pandemic, programmes in some countries proved resilient enough to recover quickly and expand during the rest of 2020—notably in Rwanda and Zambia, where programme coverage grew by about 15%.
In these countries, adjustments for the safe continuation of VMMC services during COVID-19 included changes in promotion and demand generation, client transportation, service delivery at a health facility or in the community, and post-procedure follow-up appointments. For example, personal protective equipment was provided to VMMC community mobilizers, clients and staff.
A total of about 18 million VMMCs were performed in 2016–2020, far shy of the 2020 target of 25 million. As well as COVID-19, an additional setback in 2015 and 2016 was the detection of tetanus cases in Uganda, which led to activities being scaled back in that country.